Review of the Recommendations of the

Report of the Task Force on Health and Work

for the City of Toronto

The Board of Health recommends the adoption of the recommendations embodied in the following report (January 15, 1999) from the Medical Officer of Health, amended to read as follows:

(1)the Board of Health and City Council recognize the critical link between employment and population health by supporting in principle the Report of the Task Force on Health and Work and its recommendations;

(2)the Board of Health request City Council to receive the Report and undertake a full review of and report on how the City of Toronto can implement key recommendations, in particular Recommendation No. (17); and further that Health Unit staff work with Human Resources to put together terms of reference for the review, the terms of reference to be based on the City of Toronto response outlined in this report;

(3)the Board of Health request City Council to ensure that these recommendations be considered in human resources policies as well as planning processes under development in the City of Toronto;

(4)the Board of Health request that the Human Resources Division, in consultation with appropriate Health Unit staff, the City's bargaining units and any appropriate outside experts and organizations, prepare a comprehensive report on how the City might implement a four-day work week, and other shorter work time ideas, such report to include but not be limited to:

(a)examining the use of overtime;

(b)implications for collective bargaining (some elements of which may need to be in camera);

(c)phase-in possibilities and opportunities;

(d)other municipal models within Canada and abroad; and

(e)areas where other levels of government need to become involved;

and further, that the Board of Health request Human Resources staff, working with appropriate partners within and outside the municipal corporation, to organize a series of public round tables, or other public events, that promotes a public discussion of shorter work time ideas;

(5)the Board of Health and City Council advocate to Human Resources Development Canada for the initiation and development of a voluntary collective benefits insurance fund for all Canadians in the non-standard and contingent workforce, with a further report on how this advocacy can be done; and

(6)the Executive Director of Human Resources and the Medical Officer of Health be requested to submit a report to both the Board of Health and the Corporate Services Committee in May 1999:

Purpose:

To report on the preliminary review of the recommendations of the Report of the Task Force on Health and Work.

Recommendations:

It is recommended that:

(1)the Board of Health recognize the critical link between employment and population health by supporting in principle the Report of the Task Force on Health and Work and its recommendations;

(2)the Board of Health request City Council to receive the Report and undertake a full review of and report on how the City of Toronto can implement key recommendations, in particular Recommendation No. (17);

(3)the Board of Health request City Council to ensure that these recommendations be considered in human resources policies as well as planning processes under development in the City of Toronto;

(4)the Board of Health request that, in investigating the feasibility of a four-day work week, the City of Toronto begin by monitoring overtime currently worked in the City; and

(5)the Board of Health and City Council advocate to Human Resources Development Canada for the initiation and development of a voluntary collective benefits insurance fund for all Canadians in the non-standard and contingent workforce.

Background:

The impact of conditions of employment on the overall health of the population has been documented for some time by a range of agencies and investigators. As conditions of work began to change rapidly in the 1990s, due to global economic trends affecting our domestic labour market, health impacts began to accelerate noticeably on individuals, families and communities. This impact on the health of Toronto residents was brought to the attention of the former Toronto Board of Health and was investigated by a Task Force formed specifically to make recommendations on the issue. The Report of the Task Force on Health and Work was adopted by the former City of Toronto Board of Health on September 9, 1997, and by the former City of Toronto Council on September 22 and 23, 1997 (see Appendix A for chronology).

The report was subsequently considered by the current Board of Health on April 21, 1998. The Board of Health deferred consideration of the report until the Medical Officer of Health could report on the outcome of a review by the Chief Administrative Officer and the Executive Director of Human Resources of the report's recommendations (see Appendix B for the recommendations of the Task Force on Health and Work). The following report is the result of that review. The Chief Administrative Officer and the Executive Director of Human Resources have participated in the development of this report and concur with its recommendations.

Comments:

In Canada, as in other parts of the world, lack of sustaining work remains a central determinant of the health of the population. In 1997, the National Forum on Health stated that "the most important yet the most difficult issue for the health of Canadians is the availability of jobs." One year later, the problem became acute in Ontario where, according to Statistics Canada, 14,000 jobs were lost in the month of June alone. In that month, Ontario experienced 40 percent of the total job losses in Canada, more than any other province. Many of these job losses have been sustained in the City of Toronto.

The Task Force on Health and Work highlighted work-related stress as a key factor affecting the health of Toronto residents and uncovered the following causes:

(1)many Toronto residents have no income-generating work;

(2)other Toronto residents are employed at intermittent part-time or contract work at low wages and with no benefits;

(3)the Toronto residents that have full time employment are often working long hours under difficult conditions;

(4)streamlining, downsizing and other changes in the workplace have resulted in job loss for some workers and a constant level of insecurity for others;

(5)decreases in wages and benefits have occurred for many workers as a result of global competition and restructuring;

(6)deregulation and de-skilling of the labour market has meant less access to safe, fair and sustaining conditions of employment for many workers;

(7)changes in the labour market are having a particularly negative impact on women and youth;

(8)self employment, while providing some benefits to workers, can also result in low wages and no employment benefits; and

(9)changes in technology have eliminated many jobs and resulted in increased demands on workers to match the accelerated pace of business.

While the Task Force recognized that the findings of its investigation are in part due to changes taking place globally, its recommendations provide actions that the City of Toronto could take to improve work conditions for its own employees. These actions would build on a tradition of positive municipal employee relations within the former municipalities and of providing quality services to enhance health and employment in the larger community. These actions also offer an opportunity for the City of Toronto to set an example for other employment sectors by assuming a leadership role in healthy employment policies. Moreover, in the current climate of increasingly high employee stress levels, protecting the health of its own workforce is highly desirable if the City is to realize maximum employee productivity and retention. Key actions that could be taken by the City of Toronto (Recommendation No. (17) of the Report of the Task Force on Health and Work) and the preliminary response of the City to these recommendations follow:

The Report of the Task Force on Health and Work also makes recommendations to other levels of government and the private sector in order to ensure that the goal of sustainable work is acted on provincially and nationally (Recommendations Nos. (1) to (16)).

Conclusions:

The recommendations of the Task Force on Health and Work offer an opportunity for the City of Toronto to assume a leadership role in implementing practices within its own workforce that will improve the health of its employees at a time when employment-related stress is a local, national and global concern. Many of these practices were in place in the former municipalities that now constitute the new city and build on the best traditions of a safe and healthy workplace for all municipal employees. Moreover, by providing leadership on this issue, the City of Toronto will demonstrate to other levels of government and to other employment sectors the importance of dealing substantively with the health impacts of work-related stress.

Contact Name:

Liz Janzen, Regional Director, Toronto Office, Public Health

Tel: 392-7458; Fax: 392-0713

ljanzen@toronto.ca.

Valerie Hepburn, Health Education Consultant

Tel: 392-7451; Fax: 392-1483

vhepburn@toronto.ca

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Appendix A

Report of the Task Force on Health and Work

Chronology of Events

December 1994The Report of the Advisory Group on Working Time and the Distribution of Work, chaired by economist Arthur Donner, is released by Human Resources Development Canada.

April 1996The former City of Toronto Board of Health initiates an investigation into the health effects of changes in work experienced by Toronto residents .

June 1997The federal government releases a subsequent report, Collective Reflection on the Changing Workplace.

September 8, 1997Acting President of CUPE Local 79 supports the Report and encourages the Board of Health "...to ensure that its principles become an integral part of the new government's philosophy".

September 9, 1997Report of the Task Force on Health and Work presented to and adopted by the Board of Health of the former City of Toronto.

September 22-23, 1997Former Toronto City Council adopts the Report and recommends that it also be adopted by City Council and the Board of Health for the new City of Toronto.

City Council also refers the Report to the federal Minister of Health and Human Resources and the provincial Ministers of Labour and Finance, all of whom express interest in and/or support for the Report.

January 1998Public Health staff meet with federal Minister of Health Allan Rock to discuss Recommendation No. (15) of the Report, which is congruent with recommendations of two previous federal reports.

January 26, 1998Report of the Task Force on Health and Work is considered by the interim Board of Health for the new City of Toronto.

The interim Board of Health referred the report to the first meeting of the new Board of Health and requested a presentation on the Report's recommendations.

The interim Board of Health also requested that the report be forwarded to the Executive Director of Human Resources for consideration as part of the budgetary process with specific attention to Recommendations Nos. (15), (16) and (17).

In addition, the interim Board of Health requested that this report be forwarded to all bargaining units in the City of Toronto.

April 21, 1998Peter Tabuns, Chair of the Task Force on Health and Work, presents the Task Force's findings to the Board of Health.

The Board of Health defers consideration of the Report until the Medical Officer of Health reports on the outcome of a review of the Report's recommendations by the Chief Administrative Officer and the Executive Director of Human Resources.

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Appendix B

Conclusions and Recommendations

"What do we owe one another as members of the same society who no longer inhabit the same economy?"

(United State Secretary of Labor Robert Reich, 1992)

"All initiatives related to economic well-being, social justice and health are connected and need to be thought of and planned for in relation to each other."

(Corporate president at the business leaders' focus group of the Task Force on Health and Work)

The inquiry into the changing nature of work and its effect on the health of Toronto residents revealed widespread concern about negative changes in individual and community health as a result of the trends and themes discussed in this report.

Even while the inquiry was taking place, and particularly since it ended, these trends and themes have been reinforced. Internationally, the new Multilateral Agreement on Investment (MAI) threatens to eliminate the power of nation signatories to regulate or control foreign corporations, while giving foreign corporations the right to sue governments and strike down law which are not in their interest. At the same time, here in Ontario new legislation is poised to impact workers in the public and service sectors, while new and revised labour laws continue to accelerate the devolution of worker protection and eliminate basic rights. Such examples, among others discussed earlier in this report, indicate that decision makers are moving society increasingly and further along the road to ill health.

The Task Force on Health and Work recognizes that the trends and themes identified by the inquiry are part of a changing work culture that is worldwide in scope and will continue to evolve. While we cannot change this culture, we can influence its evolution and minimize the negative health impacts. Certainly it is in the interests of decision makers, whether in the public or private sectors, to do so. We believe that a health society - one that is just, productive and peaceful - is the best indicator of a healthy future.

This perception, reinforced by the values, principles and beliefs stated earlier in this report, are the basis for the following recommendations.

General Policy Considerations:

The Task Force on Health and Work recommends:

(1)(a)that governments at all levels, as well as domestic and transnational corporations, labour and the non-profit sector, understand that the changing nature of work, and the unemployment, under-employment and over-employment that accompany it, have an impact on global health, and seek innovative solutions through the global community as well as at home; and

(b)that governments, corporations, labour and the non-profit sector investigate health-enhancing solutions to the changing nature of work which are currently being modelled in Canada and the international community, and emulate their successes with their own workforce. For example, a recent plan for the British Columbia forest industry proposes to create 6,500 new jobs while moving to a shorter work week and eliminating overtime;

(2)that in the course of negotiating the Multilateral Agreement on Investment, governments, corporations and labour build in explicit means of optimizing the health of the workforce affected by the agreement, and that such considerations become a standard feature of future international trade missions and agreements; and

(3)that all public policies, including those at the municipal level, be subjected to a health impact analysis and adjusted accordingly in order to balance economic and population health priorities. This recommendation encompasses both government economic policies and policies originating from other ministries and departments, such as labour, community and social services, industry or finance, trade and commerce, development and planning.

Federal Government Policies:

The Task Force on Health and Work recommends:

(4)that the federal government, in recognition of the fact that the health of the population, the economy, and government depends on achieving the lowest possible unemployment rates,

(a)set yearly national employment targets, similar to inflation and deficit targets, as recommended by the Centre for Policy Research Networks, and provide incentives to corporations, unions, and other stakeholders to realize them; and

(b)establish these targets with the goal of making available meaningful employment at an adequate level of income to all men and women able to work; and

(5)that the federal government ensure that the Canada Labour Code provide minimum employment standards that include working conditions and pro-rated wages and benefits for non-standard workers such as part-time, self-employed, contract and home workers.

Provincial Government Policies:

The Task Force on Health and Work recommends that the provincial government:

(6)review and amend the Employment Standards Act with the goal of strengthening key determinants of healthy work, such as sustaining wages, healthy working conditions, and individual ability to organize work and control decision making;

(7)reject proposed changes to the Employment Standards Act that would increase the maximum work week from 48 to 50 hours and create a 'flexible' or floating minimum wage;

(8)(a)extend employment standards rights to the non-standard and contingent workforce so that self-employed, freelance, part-time, contract, outsourced and home workers are fully protected by the Employment Standards Act and entitled to wages, benefits and working conditions equal to full-time and standard workers; and

(b)review employment standards on an on-going basis to assure that workers' rights are protected in a changing work culture;

(9)develop a mechanism, such as a voluntary registry for non-standard workers, as a safeguard against unjust practices and working conditions;

(10)review proposals with respect to workers' compensation to assure maximum income protection and coverage for all Ontario workers injured on the job, including those suffering mental stress and chronic pain; and

(11)rigorously enforce the Occupational Health and Safety Act, recognizing that non-union workers are especially vulnerable to reprisals for pursuing their rights, and provide assistance through the Ministry of Labour to ensure that workers understand their rights and participate in decision making related to occupational health and safety in the workplace.

Measures of Health and Work:

The Task Force on Health and Work recommends:

(12)in order to begin to comprehend and address the health effects of the changing nature of work,

(a)that the federal government seek to understand the health of the economy not just in terms of the goods and services produced (GDP), but in terms of the numbers of sustaining jobs available and the quality of life of people living in the economy, and develop through Statistics Canada measures to achieve such understanding; and

(b)that the federal government develop and use a more accurate measure of unemployment that considers the participation rate and the employment/population ratio, counts under-employed workers and those who have given up their job search, and eliminates the substitution of part-time for full-time employment.

Public Health:

The Task Force on Health and Work recommends:

(13)that all agencies that deal in public health issues continue to raise the awareness of the public and decision makers in government, labour, the corporate and non-profit sectors regarding the importance of employment as a basic prerequisite to individual, community and social health and as a means of preventing illness; and

(14)that the government of Ontario mandate and resource health units across Ontario, in the context of health promotion and advocacy programs,

(a)to identify employment-related health issues among the population they serve; and

(b)to address the issues identified for the purpose of improving individual, community and social health.

Immediate Solutions:

The Task Force on Health and Work recommends:

(15)in order to increase employment and the quality of personal, family and community life in the short term,

(a)that employers and labour explore and/or expand innovative work arrangements that optimize health, including a reduction in standard work time, flexible hours of work, job sharing, phased-in retirement education and family leave; and

(b)that governments support such initiatives based on successful models of government support in other jurisdiction; for example, the Robien Law (1996) in France. Under this law employers commit to reducing work hours and increasing staff by at least 10percent for a minimum of two years. In return the employer's payroll taxes are reduced for seven years by an amount dependent on the number of new jobs created. The reduction in payroll revenues is offset by savings in unemployment insurance and social assistance costs, and by revenues generated from a new tax-paying workforce that is consuming goods and services.

Education and Training:

The Task Force on Health and Work recommends:

(16)(a)that all levels of government enhance and co-ordinate their efforts to support a full range of relevant education and job training programs that promote employability skills in a changing job market, including literacy skills and English as a Second Language, entry level skills for young people, and comprehensive and current technological skills;

(b)that educational institutions, business, labour, government and the voluntary sector explore constructive and innovative partnership to maximize the ability of workers to find, maintain, enrich or change jobs; and

(c)that (a) and (b) above be supported by an enabling infrastructure of child care and education leave.

The New City of Toronto:

The Task Force on Health and Work recommends:

(17)that the new City of Toronto model leadership in enlightened government and healthy work in the following ways:

(a)by considering all new City policies in light of their impact on the health of workers living in the City or employed by the City;

(b)by adopting a fair wage policy so that the new City will use only those contractors that provide fair wages, benefits, working conditions and equality of opportunity to workers engaged under standards specified by the new City's fair wage office, and who agree to the monitoring and auditing of these standards by that office;

(c)by investigating the feasibility of establishing a voluntary collective benefits insurance plan for Toronto residents among the non-standard and contingent workforce as a means of centralizing contributions and payouts to individual workers;

(d)by playing an active role in supporting the health of workers in the context of a changing work culture by maintaining and extending the public programs, services and resources provided by Parks and Recreation, Public Libraries, Public Health, and the Workers' Information and Action Centre;

(e)by maintaining a public workforce of sufficient size and skills to provide excellence in the services required by a larger and more diverse population, recognizing that a public workforce is best suited to ensure access, equity, cultural sensitivity, and public accountability for those services;

(f)by maintaining good labour relations with and a healthy work environment for that workforce, in order to maximize high standards of community service delivery and capacity building;

(g)by supporting innovative approaches to work that improve productivity and enhance employment opportunities, including flex time, phased-in retirement and all forms of leave, as well as investigating the feasibility of a four-day work week; and

(h)by developing a charter for healthy work, in line with the principles and themes developed in this report, that would direct City policy and be used to influence other employers.

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Mr. Mark Hudson, representing the citizens' group "32 HOURS: Action for Full Employment", appeared before the Board of Health in connection with the foregoing matter, and submitted material with respect thereto.